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Home My WebLink About12815-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z- 16764 Date April 4, 1988 THIS CERTIFIES that the building .C.O.~.8??.T4C..T..O.N.E.. ?A~..~.~7..p .w.g.n.n. ............. 2095 Ruth Road Mattituck, New York Location of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section .... 1.0. 6. ..... Block 0.7 .......... Lot 006 Subdi¥ision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 6, 1983 pursuant to which Building Permit No. 12815 g dated..........December .... 30........' 1983 ....... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ONE FAMILY DWELLING The certificate is issued to KONSTANTINOS & HARIA DIAKOVASILIS ..................... ?oYn'o;, x .................... of the aforesaid building. Suffolk County Department of Health Approval ........ .I .3.-.8. O. 7.1.9.3.. 7... [9 ./.2.5./, ! .9.8.4. ...... UNDERWRITERS CERTIFICATE NO ................ ~.6.5.5. 8..7.0..-~..8/.2. ! ( .12.8.6. ........... N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FORM[ NO, 9 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ..... ~, ./,.,.-'./..~....~.~.~M~....~... ..... ,,,:~..:~7.c~v.z~? ........... ~:~ ........ ././.z.~ ~o .......... .~.~.~..~.~.~..c,z~...,.,~. ...... .,c.~..r.,¢,,¥~ ~ .....~..~.., ,~.~-..,"~7,cr-~.,c~....,,~-... .................. ..... *~.~.~:/.../.r./.~c~ ......................................................... , ................................................................ / County Tax Map No. 1000 Section ..... ./~...~ ....... Block ..... .C~...~. ........ Lot No..f~.~...~i ......... pursuant to application doted ..~:(~/..~-/,~..(~..~. .......... , 19~ and approved by the Building Inspector. Bulling Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 Ii ?ii' .......... II I II BLDG. DEPT, ~ TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted I~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner asto use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.(10, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3, Copy of certificate of occupancy $ 5.00, over 5 years $10.,0~ / 4.Vacant Land C.O. $ 20.00 .'~.~f/_.~ ~ 5.Updated C.O. $ 50.00 Date ..... ;'.~,'.,/.~)v. D:q ......... New C OhS Cpuc g 5 on ...... Old or Pre-existin~ ~uildin~ ....~ ....... Vacant kand ............. Hou~ No, Street Nam/et County Tax Map No. 1000 Section .... !~.6 ..... Block...7. ......... Lot ..... ~ ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.~ ...... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permi$ meets all applicable codes and r~gulations. Applicant ~ ................. Rev. 10.10-78 1ooo663 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 BUREAU OF ELECTRICITY S5 JOHN STREET, NEW YORK, NEW YORK IOOE,~ o.te August 21, ~984 ~4pplleatlonNo. onfHe ~84538-84 N 655870 THIS CERTIFIES THAT Gus Diakoza~ilis~ 2095 Ruth Rd~ MatCituck~N,Y. in tke followlng location; ~ Basement ~ 1st Fl. ~ 2nd ~. Section Block Lot was examined on l~ ug ~ 6, t984 ,,,a fo,,,a to be in compliance with the requirements of this FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FIXTURE SWITCHES OUTLETS FLUORESCENT V^PO~ 18 39 19 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS SERVICE DISCONNECT S E R V I C OTHER APPARATUS~ OF HI-LEG 4/0 Blec. room heaters: 1o2.5, 1~2.0, 3-1.5, Panels: 1~20, 200amps~ 1 GFCI, 2 su~ke detectors-~- Glenn Bradley Horco~ Ave. Mattituck,N.Y. 1195~ lic. 1227 Per- '[his certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by COPY FOR BU I.OINa DEPARTMENT. THIS COPYOF CER~IF!~CATE I~UST NOT 8~-A~LTERED IN ANY MANNER 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~r,~iNAL REMARKS: ~~-~_~ ./c~,,~ DATE~///~f INSPECTOR ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION lST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ,r. ~NAL REMARKS: FIELD %N. SP~CTION COMMENTS FOUNDkTION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ADDITIONAL COMMENTS. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTtI'OLD, N.Y. 11971 TEL. 765-1802 This is to advise yoo that the job under building permit no. 12815Z issued to K D±akova$±l±s on ._~_~J~3 .... for New Dwel~h-~-- is completed and H fi. hal inspection has ~ .... ) has not ( x )'been done. rn order to complete this file, it is necessary that a Certificate of Occupancy be iasued. Please fill out the encl. osed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with tills office for an inspection date 0ccupaney or ttae is unlawfnl without n Certificate of Occupancy. l'lease help un to clear up this matter so that legul action does not have to be taken. Thank you for ycmr prompt attention. Very truly yo~, Victor Lessard Executive Administrator VL:gar encl. FORM NO. 3 TOWN OF gOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ Date /- , 19 ~ ~ouso No. b'troet Hamlet County Tax Map No. 1000 Section . ~( .~ ....... Bloc~ ........ Lot ..... ~u~,v,,oi~;~?~:~n4 ~,~ ~o.4~/:..~'~.. ~: ~o,~o .... ~ ........... is returned herewith and disapproved on the follow~g grounds, ff~.~d~..~. ~J~-~. ........ : ..... ~..~.~-....~(...~zzJ .... ~z,.V~z~.z ........... ...... ~ . . ~'~'Z . .T 7 .... ~,.~ ..... ~ ..... ~ ~. .~- ~ , . . ,.~.. ......................... Building Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1803 Examined:~F~.....~ '.C.) ...... 19 .~.~.~' Approved . ~.C2 ....... 1 Permit No. Disapproveda/c ...... _":: ............. '7 ..... / ..... ....~:~ r .... /' ' 'F ............... (Building ~/n;~t~r) APPLICATION FOR BUILDING PERMIT Received .......... ,19... Date .~.......~- ........ INSTRUCTIONS State whether~applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . .~_~,r.,.~.~..,...,:._... __~. c.~__ ~ .................. ,..., .......... ; ........... Name of owner of premises ~..~*/~5~.~:.. ~ .f~.~.//~z~:'??~...~.~.,d~c? .g/',~d~.,.%./(.Z,(.5.~ ......... / / ~(as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.' .~'~.~ ......... Plumber's License No ....... ~. ~ ................ . Electrician s License No ................... Other Trade's License No ..... ~. ~ ............... 1. Location of land on which proposed work will be done .................................................. ................... .>..:.. ............ ...... House Number Street -- Hamlet County Tax Map No. 1000 Section .... ]..0..~o. ........ Block ...... .~ .......... Lot... ka Subdivision .~. ~..~.~ .............. Filed Map No ............... Lot ..... ~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ! a. Existing use and occupancy . . ..V....0.~...op,~...: ........................ b. Intended use and occupancy ............. ~m.~'o.~l,m~¢ .OC-Zt, r.'-"" .... , ....... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Reguiations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regtdatio~s~, and to admit authorized inspectom on premises and in building for necessary inspections. ,, ,t ...~...,:~.~.~.~ .~. ~. ~]~ ....... (Signature of applicant, or name, if a corporati~on) · .~1:1.~.... . c ...... (Mailing ad'dress of ~pplicant) o 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ~ ........ Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... Estimat'ed Cost.. · ) ............................... Fe ................................ (to be paid on filing this application) If dwelling, number of dwelling u~nits. [ ............. Number of dwelling units on each floor ................ If garage, number of cars , . .,4/r~ :.~q.~.2~. ~.. ...................................................... If business, commercial or mixed occupant0/, specify nature and extent of each type of use ..................... · ' f.~x' ' i ' pth D~mensmns o ~st~ng structure, ~f any: Front ............. Rear .............. De .............. Height .... /.'.L: ........ Number of Stories . ~.' ............... Dimensions of same structure with alterations or additions: ~'r;~; ii ~iiiiiiiiiii l~;;r' iii ~.' ~i i i Depth; ...................... Height ...................... Number of Stories ..................... Dimensions of entire new constrUction: Front Rear i Depth i /..~. Number of Stories ii i~/i .... ' ................................ Height Size of lot: Front ........... ........... Rear ...................... Depth ..................... fF o Date of Purchase ...................... Name o ormer wner ............................ Zone or use district in which prdmises are situated .................................................... Does proposed construction violate any zoning law, ordinance or regulation: ............................... Will lot be regraded ......... ih ......... ,. ; ..... Will excess fill be Y~moved frorrv premi~s: ,,Yes No Name of Owner of premises . ~./,J]~JxfZ~,,5/.~./,,f.. Address ~].'7].~. JjZ~'e.q.~'fff.,~hone~. ~.~.~'.'7./~..~.~. Name of Architect , ......... Address -- ~ Phone No ................ Name of Contractor ......... : ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. ~ TA'IE OF NEW Y~RI~,/ /; / , ,, ,, COUNTY OF., ~;5~ ' ...... ~.' ~ ~'~'~' ' ~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the : (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application'; that ail statements contained in this application are true to the best &his knowledge and belief; and that the work will be performed in t e manngr set forth in the application filed therewith. Sworn to before me this ...... : ..... ~...~..-~.. .... day o'f .... ~19~ Notary Publ'~~.~..... ~. ;." .~..7... County, Notary Publi~-, State of New Yark No. $2-0344963 8uffMk Courtly ~,_..q (Signature of applicant) Oor6mi~lon F. qg/~l Mir(ih 30, l;',ff,c : SUFFOLK CO. HEALTH DEPT. APPROVAL A ' H.S..o. ~-~-~ / STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FO. TH,S .eSIDENC~ W,LL i CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES(s, ~ ~a~ APPLICANT ~. ~, ~. ~ SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF ~ ~te~ s~pply CONSTRUCTION ONlY ~/ SUFFOLK CO. TAX MAP DESIGNATION: , DIST. SECT. BL~K PCL. ~ ~ ~ OWNERS ADDRESS: ....................... ~ ........ SEAL VAN TUYL GREEN~RT N~ YORK :J "It should be noted that since this property is located in an agricultoral area, the possibility exists theft the water supply may contain truce amounts of pesticides and/or ~itrat. es. R~ERICK VAN TUYL, P.C. LICENSED LAND S~VEYOES GREE~RT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H S. NO, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR This RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERO. ICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: ,",,"PROVED: ( SUFFOLK CO. TAX MAP DESIGNATION: DIST, SECT, BLOCK PCL /o~' '/0~; '7 ,.6 OWNERS ADDRESS: DEED:L. ~//~ P. TE~T HOLE STAMP SEAL